Although the prevalence of smoking has declined in all occupation groups, it remains high in blue-collar workers. Blue-collar workers are also likely to work in industries where they are exposed to occupational hazards and many work in small businesses that have limited resources for providing either health promotion or occupational health and safety programs. The proposed project examines the effectiveness of a county public health department-based initiative to reach blue-collar workers who are at double jeopardy for smoking and occupational exposures: it tests an integrated occupational health and safety (OHS) and smoking cessation (SC) program for small manufacturing worksites (i.e., those that employ 20-100 workers). The program is designed to be feasible: it uses communication channels and relationships already in place between county public health departments and businesses in the county to recruit workplaces, capitalizes on resources for both safety and smoking cessation that are already available, and seeks to build capacity for safety and health promotion in small businesses. A central element of the intervention is the conversion of the worksite safety committee into a safety and wellness committee whose charge is both workplace safety and health promotion. Consistent with the social contextual model of behavior change, the integrated workplace OHS-SC program targets multiple levels of influence: management and the worksite safety committee at the organizational level of influence, and workers at the interpersonal and individual levels of influence. The goals of the intensive intervention are to improve the safety climate at participating worksites, increase awareness of the business case for promoting smoking cessation and the prevalence of smoking at participating worksites, increase access to smoking cessation resources, increase support from co-workers and management for smoking cessation efforts, and decrease opportunities at the worksite to smoke. The program will use a variety of media, including group trainings, worksite events, toolkits, newsletters, health risk assessments, a website, and technical assistance phone calls. Participating worksites (n=64) will be randomly assigned to intensive and minimal intervention groups, stratified by county (n=3). The effectiveness of the intervention will be assessed by surveys of all company personnel completed at baseline and 12-month follow-up. The external validity of the project will also be evaluated, including its adoption by eligible businesses and the extent to which it reaches its intended target. PUBLIC HEALTH RELEVANCE: Blue-collar workers are at double jeopardy for high smoking rates and exposure to work hazards. The proposed project assesses the reach and effectiveness of an integrated work safety and smoking cessation program for small manufacturing worksites that is sponsored by a county public health department.